The University of Pennsylvania (Penn) School of Medicine's Department of Emergency Medicine and Department of Pediatrics, Division of Emergency Medicine, submit this application for an innovative program for clinicians already trained in treating emergency medical conditions who would benefit from formal clinical research training. A special emphasis will be placed on research training for clinicians with a demonstrated interest in life threatening cardiovascular emergencies including the emergency management of acute coronary syndromes, immediate and short-term acute myocardial infarction therapies, reversal of sudden death, and advanced resuscitation methods. This program will recruit nationally, seeking outstanding individuals who demonstrate research interests in cardiovascular emergencies specifically, as well as those with interests in acute, life threatening pulmonary and hematologic/hemorrhagic emergencies more broadly. The objective for this training program is to create a new workforce of NIH-funded clinical researchers. The program's graduates will be placed in academic institutions nationwide, resulting in a program of high national impact. Penn's proposed emergency care clinical research training program, entitled Enabling Medical Research Growth in Emergency Medicine (EMERGE), will provide formal training in clinical research. Scholars will matriculate in the Master of Science in Clinical Epidemiology (MSCE) degree program, led by faculty within Penn's Center for Clinical Epidemiology and Biostatistics (CCEB). EMERGE will provide an outstanding clinical research training environment within the emergency care settings of the three hospitals of the University of Pennsylvania Health System (UPHS) and The Children's Hospital of Pennsylvania (CHOP) and will include outstanding faculty from the Department of Emergency Medicine, Department of Pediatrics, Division of Emergency Medicine, and the CCEB. This highly focused and intensive research training program in acute time-sensitive medicine research will include coursework in emergency care research, clinical epidemiology, research methodology, clinical decision making, biostatistics, health services research, emergency exception from informed consent, regulatory requirements under exception from informed consent, and emergency medical ethics. In addition, the program will include elective courses, extensive independent readings, a research apprenticeship, and attendance at and participation in research seminars. The coursework, readings, apprenticeship, and seminars are designed to prepare Scholars for the major component on the training program: the design and completion of an independent research project in emergency care, conducted in either the Department of Emergency Medicine or The Department of Pediatrics Division of Emergency Medicine, under the direction of a highly qualified mentor team. Specifically, the program is designed to: (1) provide in-depth knowledge via formal coursework of the research challenges and methods used in clinical research with an emphasis on factors unique to the emergency setting;(2) provide research experiences with experienced faculty preceptors in research methods, emergency medicine, and acute cardiovascular, pulmonary, hematological, and traumatic injury research;and (3) establish a premier research infrastructure with a critical mass of dedicated faculty preceptors and programmatic cohesiveness to promote the development of a new generation of academic leaders and independent researchers in emergency-related conditions. Strengths of the proposed program are: (1) outstanding clinical and research environments within the top- ranked and highly regarded Department of Emergency Medicine and Department of Pediatrics Division of Emergency Medicine, which have extensive track records for well-designed and successfully conducted prospective clinical studies;(2) a long history of highly successful research training programs led by CCEB faculty;(3) a leading Center for Resuscitation Science;(4) the opportunity to recruit adult and pediatric emergency medicine trainees from UPHS and CHOP, as well as nationally;(5) the collaborative links that have been forged among participating academic entities;(6) the comprehensive course offerings and research programs available to Scholars;and (7) an extensive set of experienced program directors and faculty preceptors with successful training records. In addition, the availability of the broad range of rich expertise of the faculties in the emergency care settings at UPHS hospitals and CHOP and the clinician-scientists housed within the CCEB will ensure that Scholars graduate from EMERGE prepared for independent research careers. Further, the broad array of specialized analytic capabilities available for clinical studies (e.g., observational and experimental research designs), and the faculties'commitment to collaborative research and training, combine to provide an ideal environment for this unique and focused EMERGE program.